| 张秀丽,吕申,王朝晖,王晓梅,李梅.输尿管癌“环/线”状CT强化征及其临床意义[J].中国医学影像技术,2013,29(7):1155~1159 |
| 输尿管癌“环/线”状CT强化征及其临床意义 |
| CT imaging of ureteral carcinoma: A “ring/line” enhancement sign and its clinical significance |
| 投稿时间：2013-02-22 修订日期：2013-05-29 |
| DOI： |
| 中文关键词: 尿路肿瘤 输尿管 体层摄影术,X线计算机 微血管密度 血管内皮生长因子 炎症 尿路上皮增生 |
| 英文关键词:Urinary neoplasms Ureter Tomography, X-ray computed Microvessel density Vascular endothelial growth factor Inflammation Urothelial hyperplasia |
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| 中文摘要: |
| 目的 分析输尿管肿瘤邻近的正常输尿管壁轻度增厚及CT "环/线"状强化(简称"环/线征") 征象,探讨其对于评价输尿管癌生物学行为的意义。方法 对36例经手术病理证实的输尿管癌患者行尿路多期CT增强扫描,应用统计方法观察"环/线征"与输尿管癌的MVD计数、VEGF表达和病理分期的相关性。结果 具有"环/线征"的输尿管内膜镜下呈扁平状或乳头状增生,肿瘤中有炎性淋巴细胞浸润。重度与轻度"环线征"组间癌灶CT净强化峰值、纵径及横径的差异无统计学意义,"环/线征"与癌灶的VEGF表达和病理分期呈正相关(r's=0.471,P=0.004;r's=0.450,P=0.006)。重度组MVD计数高于轻度组及无"环/线征"组(P=0.033、0.006)。肿瘤的淋巴细胞聚集程度与"环线征"程度及病理分期、VEGF表达呈正相关 (r's=0.638,P<0.001;r's=0.461,P=0.005;r's=0.347,P=0.038)。结论 "环/线征"可能是输尿管癌灶生长增殖旺盛和伴有炎症反应引起血供需求增加所致输尿管壁微血管充血的表现,提示肿瘤存在不良进展倾向。 |
| 英文摘要: |
| Objective To observe CT imaging features of ureteral carcinoma, including minimal thickening and "ring/line" CT enhancement sign (simply called "ring/line" sign) on the ureteral wall near the tumor, and to explore the significance of the "ring/line" sign for assessing the biological behavior of ureteral carcinoma. Methods Thirty-six patients with ureteral carcinoma confirmed by pathology were enrolled. All patients underwent contrast-enhanced CT examination. Correlations between the "ring/line" sign and microvessel density (MVD), vascular endothelial growth factor (VEGF) and pathological stage of the ureteral tumor were analyzed using statistical method, respectively. Results Under microscope, the ureters with "ring/line" sign exhibited flat or papillary urothelial hyperplasia, and inflammatory lymphocyte infiltration was found in tumor tissues. There was no statistically significant difference in tumor peak net CT enhancement, longitudinal length nor transverse diameter of the tumors among different "ring/line" sign groups. The "ring/line" sign had positive correlation with the tumor VEGF expression (r's=0.471, P=0.004) and pathological stage (r's=0.450, P=0.006). MVD in the group with severe degree "ring/line" sign was higher than in the other two groups with no or mild degree "ring/line" sign (P=0.006, 0.033). The tumor lymphocyte infiltration had significant positive correlation with the "ring/line" sign (r's=0.638, P<0.001), pathological stage (r's=0.461, P=0.005) and tumor VEGF expression (r's=0.347, P=0.038). Conclusion The "ring/line" CT enhancement sign most probably suggests poor tumor progression tendency. It may indicate microvascular congestion of ureteral wall due to increased blood requirement resulting from vigorous tumor proliferation and accompanying inflammation. |
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